Search results for: Ryotaro Ishikawa
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 18

Search results for: Ryotaro Ishikawa

18 Responsibility Attitude and Interpretation in Obsessive-Compulsive Disorder

Authors: Ryotaro Ishikawa

Abstract:

Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over. Inflated responsibility attitude and interpretation are central beliefs in a cognitive model of OCD. This study aimed to develop a Japanese version of the Responsibility Attitude Scale (RAS-J) and Responsibility Interpretation Questionnaire (RIQ-J). 98 participants (OCD group = 37; anxiety control group = 24; healthy control group = 37) completed the RAS-J, RIQ-J and other measures to assess the validity of the RAS-J and RIQ-J. As a result of analysis, both scales had adequate concurrent validity, demonstrated by significant correlations with other measures of OCD, anxiety, and depression. Group comparison data using ANOVA with Bonferroni method indicated that RAS-J and RIQ-J scores for the OCD group not only differed from the nonclinical group, but also from the clinically anxious comparison group. In conclusion, this study indicated that the developed RAS-J and RIQ-J effectively measure responsibility attitude and responsibility interpretation in the Japanese population.

Keywords: obsessive-compulsive disorder, responsibility, cognitive theory, anxiety disorder

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17 Analysis of Labor Effectiveness at Green Tea Dry Sorting Workstation for Increasing Tea Factory Competitiveness

Authors: Bayu Anggara, Arita Dewi Nugrahini, Didik Purwadi

Abstract:

Dry sorting workstation needs labor to produce green tea in Gambung Tea Factory. Observation results show that there is labor who are not working at the moment and doing overtime jobs to meet production targets. The measurement of the level of labor effectiveness has never been done before. The purpose of this study is to determine the level of labor effectiveness and provide recommendations for improvement based on the results of the Pareto diagram and Ishikawa diagram. The method used to measure the level of labor effectiveness is Overall Labor Effectiveness (OLE). OLE had three indicators which are availability, performance, and quality. Recommendations are made based on the results of the Pareto diagram and Ishikawa diagram for indicators that do not meet world standards. Based on the results of the study, the OLE value was 68.19%. Recommendations given to improve labor performance are adding mechanics, rescheduling rest periods, providing special training for labor, and giving rewards to labor. Furthermore, the recommendations for improving the quality of labor are procuring water content measuring devices, create material standard policies, and rescheduling rest periods.

Keywords: Ishikawa diagram, labor effectiveness, OLE, Pareto diagram

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16 Development and Validation of the Dimensional Social Anxiety Scale: Assessment for the Offensive Type of Social Anxiety

Authors: Ryotaro Ishikawa

Abstract:

Social Anxiety Disorder (SAD) is marked by the persistent fear of social or performance situations in which embarrassment may occur. In contrast, SA in Japan and in China is understood differently. Taijin Kyofusho (TKS) is a culture-bound subtype of SAD which has been the focus of recent research. TKS refers to a unique form of SAD found in Japanese and East Asian cultures characterized by a fear of offending others, in contrast to prototypical SAD in which the source of fear is typically concerned about one’s own embarrassment, humiliation, or rejection by others. Criteria for TKS partially overlap with but are distinct from SAD; a primary factor distinguishing TKS from SAD appears to be individualistic versus interdependent or collectivistic self-construals. The aim of this study was to develop a scale to assess the typical SAD and offensive type of SAD (TKS). This study aimed to test the internal consistency and validity of the scale (Dimensional Social Anxiety Scale: DSAS) using university students sample. For this, 148 university students were enrolled (male=90, female=58, age=19.77, Standard Deviation=1.04). As a result of confirmatory factor analysis, three-factor models of DSAS were verified (χ2(74) =128.36). These three factors were named ‘general’, ‘perfomance’, and ‘offensive’. DSAS were significantly correlated with the Liebowitz Social Anxiety Scale (r = .538, p < .001). Good internal consistencies were indicated on the three subscales (α = .76 to 89). In conclusion, this study indicated DSAS has adequate internal consistency and validity for assessing of multi-type of SADs.

Keywords: social anxiety, cognitive theory, assessment, anxiety disorder

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15 A Three-Step Iterative Process for Common Fixed Points of Three Contractive-Like Operators

Authors: Safeer Hussain Khan, H. Fukhar-ud-Din

Abstract:

The concept of quasi-contractive type operators was given by Berinde and extended by Imoru and Olatinwo. They named this new type as contractive-like operators. On the other hand, Xu and Noo introduced a three-step-one-mappings iterative process which can be seen as a generalization of Mann and Ishikawa iterative processes. Approximating common fixed points has its own importance as it has a direct link with minimization problem. Motivated by this, in this paper, we first extend the iterative process of Xu and Noor to the case of three-step-three-mappings and then prove a strong convergence result using contractive-like operators for this iterative process. In general, this generalizes corresponding results using Mann, Ishikawa and Xu-Noor iterative processes with quasi-contractive type operators. It is to be pointed out that our results can also be proved with iterative process involving error terms.

Keywords: contractive-like operator, iterative process, common fixed point, strong convergence

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14 A Cognitive Behavioural Therapy for Post-Traumatic Stress Disorders

Authors: Ryotaro Ishikawa

Abstract:

INTRODUCTION: Post-traumatic stress disorder (PTSD) is a psychiatric label for a collection of psychological symptoms following a traumatic event. PTSD is as a result of a traumatic experience such as rape or sexual assault. A victim may have PTSD if she/he has experienced the following symptoms for at least a month: a) Stressor, b) Intrusion symptoms, c) Avoidance, d) Negative alterations in cognitions and mood, e) Alterations in arousal and reactivity. Studies on the cognitive theory of PTSD emphasized the roles of (a) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (b) disorganized trauma memories in the development of PTSD. Mental contamination is primarily caused by experiences involving humans (e.g. violators or perpetrators) as opposed to substances (e.g. dirt or bodily fluids). Feelings of mental contamination may evoke following experiences of ill-treatment, sexual assault, domination, degradation, manipulation, betrayal, or humiliation. Some studies have demonstrated that traumatic thoughts related to sexual assault are particularly strong predictors of mental contamination. Treatment protocols based on cognitive-behavioral therapy appear to be beneficial in reducing the severity of PTSD and mental contamination. Studies on the cognitive theory of PTSD emphasized the roles of (A) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (B) disorganized trauma memories in the development of PTSD. We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. METHOD: The single-arm trial is a group setting CBT intervention. The primary outcome is the self-rated Posttraumatic Stress Diagnostic Scale, with secondary measurements of depressive severity and mental pollution questionnaire. Assessments are conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. RESULTS: Participants are eligible for the study and complete the outcome measures at all assessment points. In our hypothesis, receiving CBT would lead to improvements in primary and secondary PTSD severity. CONCLUSION: We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. Our treatment would achieve favorable treatment outcomes for PTSD with mental contamination in Japanese clinical settings.

Keywords: CBT, cognitive theory, PTSD, mental pollution

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13 Approximating Fixed Points by a Two-Step Iterative Algorithm

Authors: Safeer Hussain Khan

Abstract:

In this paper, we introduce a two-step iterative algorithm to prove a strong convergence result for approximating common fixed points of three contractive-like operators. Our algorithm basically generalizes an existing algorithm..Our iterative algorithm also contains two famous iterative algorithms: Mann iterative algorithm and Ishikawa iterative algorithm. Thus our result generalizes the corresponding results proved for the above three iterative algorithms to a class of more general operators. At the end, we remark that nothing prevents us to extend our result to the case of the iterative algorithm with error terms.

Keywords: contractive-like operator, iterative algorithm, fixed point, strong convergence

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12 Basis Theorem of Equivalence of Explicit-Type Iterations for the Class of Multivalued Phi-Quasi-Contrative Maps in Modular Function Spaces

Authors: Hudson Akewe

Abstract:

We prove that the convergence of explicit Mann, explicit Ishikawa, explicit Noor, explicit SP, explicit multistep and explicit multistep-SP fixed point iterative procedures are equivalent for the classes of multi-valued phi-contraction, phi-Zamfirescu and phi-quasi-contractive mappings in the framework of modular function spaces. Our results complement equivalence results on normed and metric spaces in the literature as they elegantly cut out the triangle inequality.

Keywords: multistep iterative procedures, multivalued mappings, equivalence results, fixed point

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11 Frequency- and Content-Based Tag Cloud Font Distribution Algorithm

Authors: Ágnes Bogárdi-Mészöly, Takeshi Hashimoto, Shohei Yokoyama, Hiroshi Ishikawa

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The spread of Web 2.0 has caused user-generated content explosion. Users can tag resources to describe and organize them. Tag clouds provide rough impression of relative importance of each tag within overall cloud in order to facilitate browsing among numerous tags and resources. The goal of our paper is to enrich visualization of tag clouds. A font distribution algorithm has been proposed to calculate a novel metric based on frequency and content, and to classify among classes from this metric based on power law distribution and percentages. The suggested algorithm has been validated and verified on the tag cloud of a real-world thesis portal.

Keywords: tag cloud, font distribution algorithm, frequency-based, content-based, power law

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10 Analysis of Supply Chain Risk Management Strategies: Case Study of Supply Chain Disruptions

Authors: Marcelo Dias Carvalho, Leticia Ishikawa

Abstract:

Supply Chain Risk Management refers to a set of strategies used by companies to avoid supply chain disruption caused by damage at production facilities, natural disasters, capacity issues, inventory problems, incorrect forecasts, and delays. Many companies use the techniques of the Toyota Production System, which in a way goes against a better management of supply chain risks. This paper studies key events in some multinationals to analyze the trade-off between the best supply chain risk management techniques and management policies designed to create lean enterprises. The result of a good balance of these actions is the reduction of losses, increased customer trust in the company and better preparedness to face the general risks of a supply chain.

Keywords: just in time, lean manufacturing, supply chain disruptions, supply chain management

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9 Wet Polymeric Precipitation Synthesis for Monophasic Tricalcium Phosphate

Authors: I. Grigoraviciute-Puroniene, K. Tsuru, E. Garskaite, Z. Stankeviciute, A. Beganskiene, K. Ishikawa, A. Kareiva

Abstract:

Tricalcium phosphate (β-Ca3(PO4)2, β-TCP) powders were synthesized using wet polymeric precipitation method for the first time to our best knowledge. The results of X-ray diffraction analysis showed the formation of almost single a Ca-deficient hydroxyapatite (CDHA) phase of a poor crystallinity already at room temperature. With continuously increasing the calcination temperature up to 800 °C, the crystalline β-TCP was obtained as the main phase. It was demonstrated that infrared spectroscopy is very effective method to characterize the formation of β-TCP. The SEM results showed that β-TCP solids were homogeneous having a small particle size distribution. The β-TCP powders consisted of spherical particles varying in size from 100 to 300 nm. Fabricated β-TCP specimens were placed to the bones of the rats and maintained for 1-2 months.

Keywords: Tricalcium phosphate (β-Ca3(PO4)2, bone regeneration, wet chemical processing, polymeric precipitation

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8 Simulation Data Summarization Based on Spatial Histograms

Authors: Jing Zhao, Yoshiharu Ishikawa, Chuan Xiao, Kento Sugiura

Abstract:

In order to analyze large-scale scientific data, research on data exploration and visualization has gained popularity. In this paper, we focus on the exploration and visualization of scientific simulation data, and define a spatial V-Optimal histogram for data summarization. We propose histogram construction algorithms based on a general binary hierarchical partitioning as well as a more specific one, the l-grid partitioning. For effective data summarization and efficient data visualization in scientific data analysis, we propose an optimal algorithm as well as a heuristic algorithm for histogram construction. To verify the effectiveness and efficiency of the proposed methods, we conduct experiments on the massive evacuation simulation data.

Keywords: simulation data, data summarization, spatial histograms, exploration, visualization

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7 Critical Analysis of Heat Exchanger Cycle for its Maintainability Using Failure Modes and Effect Analysis and Pareto Analysis

Authors: Sayali Vyas, Atharva Desai, Shreyas Badave, Apurv Kulkarni, B. Rajiv

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The Failure Modes and Effect Analysis (FMEA) is an efficient evaluation technique to identify potential failures in products, processes, and services. FMEA is designed to identify and prioritize failure modes. It proves to be a useful method for identifying and correcting possible failures at its earliest possible level so that one can avoid consequences of poor performance. In this paper, FMEA tool is used in detection of failures of various components of heat exchanger cycle and to identify critical failures of the components which may hamper the system’s performance. Further, a detailed Pareto analysis is done to find out the most critical components of the cycle, the causes of its failures, and possible recommended actions. This paper can be used as a checklist which will help in maintainability of the system.

Keywords: FMEA, heat exchanger cycle, Ishikawa diagram, pareto analysis, RPN (Risk Priority Number)

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6 [Keynote Talk]: From Clinical Practice to Academic Setup, 'Quality Circles' for Quality Outputs in Both

Authors: Vandita Mishra

Abstract:

From the management of patients, reception, record, and assistants in a clinical practice; to the management of ongoing research, clinical cases and department profile in an academic setup, the healthcare provider has to deal with all of it. The victory lies in smooth running of the show in both the above situations with an apt solution of problems encountered and smooth management of crisis faced. Thus this paper amalgamates dental science with health administration by means of introduction of a concept for practice management and problem-solving called 'Quality Circles'. This concept uses various tools for problem solving given by experts from different fields. QC tools can be applied in both clinical and academic settings in dentistry for better productivity and for scientifically approaching the process of continuous improvement in both the categories. When approached through QC, our organization showed better patient outcomes and more patient satisfaction. Introduced in 1962 by Kaoru Ishikawa, this tool has been extensively applied in certain fields outside dentistry and healthcare. By exemplification of some clinical cases and virtual scenarios, the tools of Quality circles will be elaborated and discussed upon.

Keywords: academics, dentistry, healthcare, quality

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5 Cone Contrast Sensitivity of Normal Trichromats and Those with Red-Green Dichromats

Authors: Tatsuya Iizuka, Takushi Kawamorita, Tomoya Handa, Hitoshi Ishikawa

Abstract:

We report normative cone contrast sensitivity values and sensitivity and specificity values for a computer-based color vision test, the cone contrast test-HD (CCT-HD). The participants included 50 phakic eyes with normal color vision (NCV) and 20 dichromatic eyes (ten with protanopia and ten with deuteranopia). The CCT-HD was used to measure L, M, and S-CCT-HD scores (color vision deficiency, L-, M-cone logCS≦1.65, S-cone logCS≦0.425) to investigate the sensitivity and specificity of CCT-HD based on anomalous-type diagnosis with animalscope. The mean ± standard error L-, M-, S-cone logCS for protanopia were 0.90±0.04, 1.65±0.03, and 0.63±0.02, respectively; for deuteranopia 1.74±0.03, 1.31±0.03, and 0.61±0.06, respectively; and for age-matched NCV were 1.89±0.04, 1.84±0.04, and 0.60±0.03, respectively, with significant differences for each group except for S-CCT-HD (Bonferroni corrected α = 0.0167, p < 0.0167). The sensitivity and specificity of CCT-HD were 100% for protan and deutan in diagnosing abnormal types from 20 to 64 years of age, but the specificity decreased to 65% for protan and 55% for deutan in older persons > 65. CCT-HD is comparable to the diagnostic performance of the anomalous type in the anomaloscope for the 20-64-year-old age group. However, the results should be interpreted cautiously in those ≥ 65 years. They are more susceptible to acquired color vision deficiencies due to the yellowing of the crystalline lens and other factors.

Keywords: cone contrast test HD, color vision test, congenital color vision deficiency, red-green dichromacy, cone contrast sensitivity

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4 Assessing Project Performance through Work Sampling and Earned Value Analysis

Authors: Shobha Ramalingam

Abstract:

The majority of the infrastructure projects are affected by time overrun, resulting in project delays and subsequently cost overruns. Time overrun may vary from a few months to as high as five or more years, placing the project viability at risk. One of the probable reasons noted in the literature for this outcome in projects is due to poor productivity. Researchers contend that productivity in construction has only marginally increased over the years. While studies in the literature have extensively focused on time and cost parameters in projects, there are limited studies that integrate time and cost with productivity to assess project performance. To this end, a study was conducted to understand the project delay factors concerning cost, time and productivity. A case-study approach was adopted to collect rich data from a nuclear power plant project site for two months through observation, interviews and document review. The data were analyzed using three different approaches for a comprehensive understanding. Foremost, a root-cause analysis was performed on the data using Ishikawa’s fish-bone diagram technique to identify the various factors impacting the delay concerning time. Based on it, a questionnaire was designed and circulated to concerned executives, including project engineers and contractors to determine the frequency of occurrence of the delay, which was then compiled and presented to the management for a possible solution to mitigate. Second, a productivity analysis was performed on select activities, including rebar bending and concreting through a time-motion study to analyze product performance. Third, data on cost of construction for three years allowed analyzing the cost performance using earned value management technique. All three techniques allowed to systematically and comprehensively identify the key factors that deter project performance and productivity loss in the construction of the nuclear power plant project. The findings showed that improper planning and coordination between multiple trades, concurrent operations, improper workforce and material management, fatigue due to overtime were some of the key factors that led to delays and poor productivity. The findings are expected to act as a stepping stone for further research and have implications for practitioners.

Keywords: earned value analysis, time performance, project costs, project delays, construction productivity

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3 The Effectiveness of Intervention Methods for Repetitive Behaviors in Preschool Children with Autism Spectrum Disorder: A Systematic Review

Authors: Akane Uda, Ami Tabata, Mi An, Misa Komaki, Ryotaro Ito, Mayumi Inoue, Takehiro Sasai, Yusuke Kusano, Toshihiro Kato

Abstract:

Early intervention is recommended for children with autism spectrum disorder (ASD), and an increasing number of children have received support and intervention before school age in recent years. In this study, we systematically reviewed preschool interventions focused on repetitive behaviors observed in children with ASD, which are often observed at younger ages. Inclusion criteria were as follows : (1) Child of preschool status (age ≤ 7 years) with a diagnosis of ASD (including autism, Asperger's, and pervasive developmental disorder) or a parent (caregiver) with a preschool child with ASD, (2) Physician-confirmed diagnosis of ASD (autism, Asperger's, and pervasive developmental disorder), (3) Interventional studies for repetitive behaviors, (4) Original articles published within the past 10 years (2012 or later), (5) Written in English and Japanese. Exclusion criteria were as follows: (1) Systematic reviews or meta-analyses, (2) Conference reports or books. We carefully scrutinized databases to remove duplicate references and used a two-step screening process to select papers. The primary screening included close scrutiny of titles and abstracts to exclude articles that did not meet the eligibility criteria. During the secondary screening, we carefully read the complete text to assess eligibility, which was double-checked by six members at the laboratory. Disagreements were resolved through consensus-based discussion. Our search yielded 304 papers, of which nine were included in the study. The level of evidence was as follows: three randomized controlled trials (level 2), four pre-post studies (level 4b), and two case reports (level 5). Seven articles selected for this study described the effectiveness of interventions. Interventions for repetitive behaviors in preschool children with ASD were categorized as five interventions that directly involved the child and four educational programs for caregivers and parents. Studies that directly intervened with children used early intensive intervention based on applied behavior analysis (Early Start Denver Model, Early Intensive Behavioral Intervention, and the Picture Exchange Communication System) and individualized education based on sensory integration. Educational interventions for caregivers included two methods; (a) education regarding combined methods and practices of applied behavior analysis in addition to classification and coping methods for repetitive behaviors, and (b) education regarding evaluation methods and practices based on children’s developmental milestones in play. With regard to the neurophysiological basis of repetitive behaviors, environmental factors are implicated as possible contributors. We assumed that applied behavior analysis was shown to be effective in reducing repetitive behaviors because analysis focused on the interaction between the individual and the environment. Additionally, with regard to educational interventions for caregivers, the intervention was shown to promote behavioral change in children based on the caregivers' understanding of the classification of repetitive behaviors and the children’s developmental milestones in play and adjustment of the person-environment context led to a reduction in repetitive behaviors.

Keywords: autism spectrum disorder, early intervention, repetitive behaviors, systematic review

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2 Quality Improvement of the Sand Moulding Process in Foundries Using Six Sigma Technique

Authors: Cindy Sithole, Didier Nyembwe, Peter Olubambi

Abstract:

The sand casting process involves pattern making, mould making, metal pouring and shake out. Every step in the sand moulding process is very critical for production of good quality castings. However, waste generated during the sand moulding operation and lack of quality are matters that influences performance inefficiencies and lack of competitiveness in South African foundries. Defects produced from the sand moulding process are only visible in the final product (casting) which results in increased number of scrap, reduced sales and increases cost in the foundry. The purpose of this Research is to propose six sigma technique (DMAIC, Define, Measure, Analyze, Improve and Control) intervention in sand moulding foundries and to reduce variation caused by deficiencies in the sand moulding process in South African foundries. Its objective is to create sustainability and enhance productivity in the South African foundry industry. Six sigma is a data driven method to process improvement that aims to eliminate variation in business processes using statistical control methods .Six sigma focuses on business performance improvement through quality initiative using the seven basic tools of quality by Ishikawa. The objectives of six sigma are to eliminate features that affects productivity, profit and meeting customers’ demands. Six sigma has become one of the most important tools/techniques for attaining competitive advantage. Competitive advantage for sand casting foundries in South Africa means improved plant maintenance processes, improved product quality and proper utilization of resources especially scarce resources. Defects such as sand inclusion, Flashes and sand burn on were some of the defects that were identified as resulting from the sand moulding process inefficiencies using six sigma technique. The courses were we found to be wrong design of the mould due to the pattern used and poor ramming of the moulding sand in a foundry. Six sigma tools such as the voice of customer, the Fishbone, the voice of the process and process mapping were used to define the problem in the foundry and to outline the critical to quality elements. The SIPOC (Supplier Input Process Output Customer) Diagram was also employed to ensure that the material and process parameters were achieved to ensure quality improvement in a foundry. The process capability of the sand moulding process was measured to understand the current performance to enable improvement. The Expected results of this research are; reduced sand moulding process variation, increased productivity and competitive advantage.

Keywords: defects, foundries, quality improvement, sand moulding, six sigma (DMAIC)

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1 Distribution Routs Redesign through the Vehicle Problem Routing in Havana Distribution Center

Authors: Sonia P. Marrero Duran, Lilian Noya Dominguez, Lisandra Quintana Alvarez, Evert Martinez Perez, Ana Julia Acevedo Urquiaga

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Cuban business and economic policy are in the constant update as well as facing a client ever more knowledgeable and demanding. For that reason become fundamental for companies competitiveness through the optimization of its processes and services. One of the Cuban’s pillars, which has been sustained since the triumph of the Cuban Revolution back in 1959, is the free health service to all those who need it. This service is offered without any charge under the concept of preserving human life, but it implied costly management processes and logistics services to be able to supply the necessary medicines to all the units who provide health services. One of the key actors on the medicine supply chain is the Havana Distribution Center (HDC), which is responsible for the delivery of medicines in the province; as well as the acquisition of medicines from national and international producers and its subsequent transport to health care units and pharmacies in time, and with the required quality. This HDC also carries for all distribution centers in the country. Given the eminent need to create an actor in the supply chain that specializes in the medicines supply, the possibility of centralizing this operation in a logistics service provider is analyzed. Based on this decision, pharmacies operate as clients of the logistic service center whose main function is to centralize all logistics operations associated with the medicine supply chain. The HDC is precisely the logistic service provider in Havana and it is the center of this research. In 2017 the pharmacies had affectations in the availability of medicine due to deficiencies in the distribution routes. This is caused by the fact that they are not based on routing studies, besides the long distribution cycle. The distribution routs are fixed, attend only one type of customer and there respond to a territorial location by the municipality. Taking into consideration the above-mentioned problem, the objective of this research is to optimize the routes system in the Havana Distribution Center. To accomplish this objective, the techniques applied were document analysis, random sampling, statistical inference and tools such as Ishikawa diagram and the computerized software’s: ArcGis, Osmand y MapIfnfo. As a result, were analyzed four distribution alternatives; the actual rout, by customer type, by the municipality and the combination of the two last. It was demonstrated that the territorial location alternative does not take full advantage of the transportation capacities or the distance of the trips, which leads to elevated costs breaking whit the current ways of distribution and the currents characteristics of the clients. The principal finding of the investigation was the optimum option distribution rout is the 4th one that is formed by hospitals and the join of pharmacies, stomatology clinics, polyclinics and maternal and elderly homes. This solution breaks the territorial location by the municipality and permits different distribution cycles in dependence of medicine consumption and transport availability.

Keywords: computerized geographic software, distribution, distribution routs, vehicle problem routing (VPR)

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